{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:08:36Z","timestamp":1777853316259,"version":"3.51.4"},"reference-count":24,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Assoc Provid AIDS Care"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Long-term evidence from resource-limited settings spanning transitions in HIV care is scarce. We describe 25-year outcomes from a pragmatic Indian cohort employing simplified regimens and strategic drug sequencing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Treatment-na\u00efve adults initiated dual-nucleoside reverse transcriptase inhibitor therapy (2000-2025), reserving protease and integrase inhibitors for later lines (\u201cclass preservation\u201d). Primary outcomes were survival and treatment durability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 971 patients retained in care (12,438 patient-years), Kaplan-Meier survival was 95.8% at 5 years and 88.3% at 25 years. Median first-line durability was 8.3 years. Overall, 85% achieved \u226595% adherence. Opportunistic infection incidence declined from 451.5 to 69.7 per 1000 patient-years. Clinically driven monitoring saved US$7578 per patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>For patients retained in continuous care, strategic sequencing, intensive adherence support, and provider continuity sustained durable outcomes over 25 years. These findings characterize outcomes achievable under sustained engagement rather than population-level results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259582261444528","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T13:31:22Z","timestamp":1776951082000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pragmatic Strategies for Sustaining HIV Care: 25-Year Outcomes from an Independent Practice in India"],"prefix":"10.1177","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2484-8123","authenticated-orcid":false,"given":"Murali K","family":"Yanamadala","sequence":"first","affiliation":[{"name":"Consultant Physician Lakshmi Vaidyasala, HIV and Infectious Diseases Specialty Medical Centre, Kakinada, Andhra Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"e_1_3_3_2_2","volume-title":"Global report: UNAIDS report on the global AIDS epidemic 2010","author":"UNAIDS","year":"2010","unstructured":"UNAIDS. 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Dual therapy with lopinavir\/ritonavir plus lamivudine versus triple therapy for maintenance of HIV-1 viral suppression (OLE): A randomised, open-label, non-inferiority trial. Lancet HIV. 2015;2(10):e417\u2013e425.","journal-title":"Lancet HIV"},{"key":"e_1_3_3_10_2","first-page":"975","article-title":"Dual therapy with darunavir\/ritonavir plus lamivudine versus triple therapy in treatment-na\u00efve adults","volume":"19","author":"Cahn P","year":"2019","unstructured":"Cahn P, Sierra Madero J, Arribas JR, et al. Dual therapy with darunavir\/ritonavir plus lamivudine versus triple therapy in treatment-na\u00efve adults. 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HIV\u2013TB co-infection: Epidemiology, diagnosis and management. Indian J Med Res. 2005;121(4):550\u2013567.","journal-title":"Indian J Med Res"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1086\/651492"},{"key":"e_1_3_3_21_2","doi-asserted-by":"crossref","unstructured":"Yanamadala VMKR. Two-drug ART in treatment na\u00efve HIV-infected persons in resource-limited setting: 2-year study [abstract PP 4.40]. In: Final Program & Abstracts Book. 13th International Symposium on HIV & Emerging Infectious Diseases (ISHEID); 2004 Jun 3\u20135; Toulon France. p. 277.","DOI":"10.1310\/WEKP-LKAN-TAAJ-XMPL"},{"key":"e_1_3_3_22_2","volume-title":"Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach","author":"World Health Organization","year":"2016","unstructured":"World Health Organization. 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